New Patient Form

If you are having trouble submitting your form, your antivirus software may be blocking the submission. Please try submitting on your mobile device or you can copy and paste the following link into your antivirus software's exceptions.

To add to the exception/exclusion list:

1) Open your antivirus software and find the exceptions/exclusions.

2) Copy the following link: https://leads.clouddashboard.online/*

3) Paste link in the correct location within your software and save. The form should now submit without an error.